Cargando…

Reduction in Serum Uric Acid May Be Related to Methotrexate Efficacy in Early Rheumatoid Arthritis: Data from the Canadian Early Arthritis Cohort (CATCH)

OBJECTIVES: The mechanism of action of methotrexate in rheumatoid arthritis (RA) is complex. It may increase adenosine levels by blocking its conversion to uric acid (UA). This study was done to determine if methotrexate lowers UA in early RA (ERA). METHODS: Data were obtained from Canadian Early Ar...

Descripción completa

Detalles Bibliográficos
Autores principales: Lee, Jason J., Bykerk, Vivian P., Dresser, George K., Boire, Gilles, Haraoui, Boulos, Hitchon, Carol, Thorne, Carter, Tin, Diane, Jamal, Shahin, Keystone, Edward C., Pope, Janet E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Libertas Academica 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4821431/
https://www.ncbi.nlm.nih.gov/pubmed/27081318
http://dx.doi.org/10.4137/CMAMD.S38092
_version_ 1782425587713835008
author Lee, Jason J.
Bykerk, Vivian P.
Dresser, George K.
Boire, Gilles
Haraoui, Boulos
Hitchon, Carol
Thorne, Carter
Tin, Diane
Jamal, Shahin
Keystone, Edward C.
Pope, Janet E.
author_facet Lee, Jason J.
Bykerk, Vivian P.
Dresser, George K.
Boire, Gilles
Haraoui, Boulos
Hitchon, Carol
Thorne, Carter
Tin, Diane
Jamal, Shahin
Keystone, Edward C.
Pope, Janet E.
author_sort Lee, Jason J.
collection PubMed
description OBJECTIVES: The mechanism of action of methotrexate in rheumatoid arthritis (RA) is complex. It may increase adenosine levels by blocking its conversion to uric acid (UA). This study was done to determine if methotrexate lowers UA in early RA (ERA). METHODS: Data were obtained from Canadian Early Arthritis Cohort, an incident ERA cohort. All ERA patients with serial UA measurements were included, comparing those with methotrexate use vs. no methotrexate exposure (controls). Analyses were exploratory. Patients with concomitant gout or taking UA-lowering therapies were excluded. RESULTS: In total, 49 of the 2,524 ERA patients were identified with data available for both pre-methotrexate UA levels and post-methotrexate UA levels (300 µmol/L and 273 µmol/L, respectively; P = 0.035). The control group not taking methotrexate had a mean baseline UA level of 280 µmol/L and a follow-up level of 282 µmol/L (P = 0.448); mean change in UA with methotrexate was −26.8 µmol/L vs. 2.3 µmol/L in the no methotrexate group (P = 0.042). Methotrexate users with a decrease in UA had a disease activity score of 2.37 for 28 joints when compared with the controls (3.26) at 18 months (P = 0.042). Methotrexate users with decreased UA had a lower swollen joint count (SJC) of 0.9 at 18 months, whereas methotrexate users without lowering of UA had an SJC of 4.5 (P = 0.035). Other analyses were not significant. CONCLUSIONS: Methotrexate response is associated with lowering of serum UA in ERA compared to nonusers. This may be due to changes in adenosine levels. Methotrexate response is associated with lower UA and fewer swollen joints compared to nonresponders.
format Online
Article
Text
id pubmed-4821431
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Libertas Academica
record_format MEDLINE/PubMed
spelling pubmed-48214312016-04-14 Reduction in Serum Uric Acid May Be Related to Methotrexate Efficacy in Early Rheumatoid Arthritis: Data from the Canadian Early Arthritis Cohort (CATCH) Lee, Jason J. Bykerk, Vivian P. Dresser, George K. Boire, Gilles Haraoui, Boulos Hitchon, Carol Thorne, Carter Tin, Diane Jamal, Shahin Keystone, Edward C. Pope, Janet E. Clin Med Insights Arthritis Musculoskelet Disord Original Research OBJECTIVES: The mechanism of action of methotrexate in rheumatoid arthritis (RA) is complex. It may increase adenosine levels by blocking its conversion to uric acid (UA). This study was done to determine if methotrexate lowers UA in early RA (ERA). METHODS: Data were obtained from Canadian Early Arthritis Cohort, an incident ERA cohort. All ERA patients with serial UA measurements were included, comparing those with methotrexate use vs. no methotrexate exposure (controls). Analyses were exploratory. Patients with concomitant gout or taking UA-lowering therapies were excluded. RESULTS: In total, 49 of the 2,524 ERA patients were identified with data available for both pre-methotrexate UA levels and post-methotrexate UA levels (300 µmol/L and 273 µmol/L, respectively; P = 0.035). The control group not taking methotrexate had a mean baseline UA level of 280 µmol/L and a follow-up level of 282 µmol/L (P = 0.448); mean change in UA with methotrexate was −26.8 µmol/L vs. 2.3 µmol/L in the no methotrexate group (P = 0.042). Methotrexate users with a decrease in UA had a disease activity score of 2.37 for 28 joints when compared with the controls (3.26) at 18 months (P = 0.042). Methotrexate users with decreased UA had a lower swollen joint count (SJC) of 0.9 at 18 months, whereas methotrexate users without lowering of UA had an SJC of 4.5 (P = 0.035). Other analyses were not significant. CONCLUSIONS: Methotrexate response is associated with lowering of serum UA in ERA compared to nonusers. This may be due to changes in adenosine levels. Methotrexate response is associated with lower UA and fewer swollen joints compared to nonresponders. Libertas Academica 2016-04-04 /pmc/articles/PMC4821431/ /pubmed/27081318 http://dx.doi.org/10.4137/CMAMD.S38092 Text en © 2016 the author(s), publisher and licensee Libertas Academica Ltd. This is an open-access article distributed under the terms of the Creative Commons CC-BY-NC 3.0 License.
spellingShingle Original Research
Lee, Jason J.
Bykerk, Vivian P.
Dresser, George K.
Boire, Gilles
Haraoui, Boulos
Hitchon, Carol
Thorne, Carter
Tin, Diane
Jamal, Shahin
Keystone, Edward C.
Pope, Janet E.
Reduction in Serum Uric Acid May Be Related to Methotrexate Efficacy in Early Rheumatoid Arthritis: Data from the Canadian Early Arthritis Cohort (CATCH)
title Reduction in Serum Uric Acid May Be Related to Methotrexate Efficacy in Early Rheumatoid Arthritis: Data from the Canadian Early Arthritis Cohort (CATCH)
title_full Reduction in Serum Uric Acid May Be Related to Methotrexate Efficacy in Early Rheumatoid Arthritis: Data from the Canadian Early Arthritis Cohort (CATCH)
title_fullStr Reduction in Serum Uric Acid May Be Related to Methotrexate Efficacy in Early Rheumatoid Arthritis: Data from the Canadian Early Arthritis Cohort (CATCH)
title_full_unstemmed Reduction in Serum Uric Acid May Be Related to Methotrexate Efficacy in Early Rheumatoid Arthritis: Data from the Canadian Early Arthritis Cohort (CATCH)
title_short Reduction in Serum Uric Acid May Be Related to Methotrexate Efficacy in Early Rheumatoid Arthritis: Data from the Canadian Early Arthritis Cohort (CATCH)
title_sort reduction in serum uric acid may be related to methotrexate efficacy in early rheumatoid arthritis: data from the canadian early arthritis cohort (catch)
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4821431/
https://www.ncbi.nlm.nih.gov/pubmed/27081318
http://dx.doi.org/10.4137/CMAMD.S38092
work_keys_str_mv AT leejasonj reductioninserumuricacidmayberelatedtomethotrexateefficacyinearlyrheumatoidarthritisdatafromthecanadianearlyarthritiscohortcatch
AT bykerkvivianp reductioninserumuricacidmayberelatedtomethotrexateefficacyinearlyrheumatoidarthritisdatafromthecanadianearlyarthritiscohortcatch
AT dressergeorgek reductioninserumuricacidmayberelatedtomethotrexateefficacyinearlyrheumatoidarthritisdatafromthecanadianearlyarthritiscohortcatch
AT boiregilles reductioninserumuricacidmayberelatedtomethotrexateefficacyinearlyrheumatoidarthritisdatafromthecanadianearlyarthritiscohortcatch
AT haraouiboulos reductioninserumuricacidmayberelatedtomethotrexateefficacyinearlyrheumatoidarthritisdatafromthecanadianearlyarthritiscohortcatch
AT hitchoncarol reductioninserumuricacidmayberelatedtomethotrexateefficacyinearlyrheumatoidarthritisdatafromthecanadianearlyarthritiscohortcatch
AT thornecarter reductioninserumuricacidmayberelatedtomethotrexateefficacyinearlyrheumatoidarthritisdatafromthecanadianearlyarthritiscohortcatch
AT tindiane reductioninserumuricacidmayberelatedtomethotrexateefficacyinearlyrheumatoidarthritisdatafromthecanadianearlyarthritiscohortcatch
AT jamalshahin reductioninserumuricacidmayberelatedtomethotrexateefficacyinearlyrheumatoidarthritisdatafromthecanadianearlyarthritiscohortcatch
AT keystoneedwardc reductioninserumuricacidmayberelatedtomethotrexateefficacyinearlyrheumatoidarthritisdatafromthecanadianearlyarthritiscohortcatch
AT popejanete reductioninserumuricacidmayberelatedtomethotrexateefficacyinearlyrheumatoidarthritisdatafromthecanadianearlyarthritiscohortcatch